Development of WHONET for Surveillance of Infections and Drug Resistance John Stelling, MD, MPH Project Summary/Abstract The continued emergence of infectious diseases, newly identified pathogens, and multi-drug resistant microorganisms, such as MRSA, VRE, and MDR-TB, is a global priority which threatens patient welfare worldwide and drains limited healthcare resources. Yet the effectiveness of public health strategies for containment and the feasibility of government mandates to track and decrease infections is limited by inadequate tools and information bases for action. The existing, yet dispersed, repositories of test results locked into paper logbooks and incompatible computer systems in microbiology laboratories worldwide constitutes a complexly rich, yet largely untapped resource for tracking the emergence, transmission, and evolutionary spread of microbial populations. With four decades of experience in the development of software to track emerging trends in antimicrobial resistance, our team at the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance, Boston, in coordination with the national, regional, and world headquarters of the World Health Organization, has been a leader in mobilizing and normalizing this information resource to support coordinated scientific investigations and public health action. A cornerstone of our efforts has been the development and dissemination of the WHONET software, a flexible, sophisticated, user-friendly tool for the management and analysis of microbiology test results. WHONET is utilized in over 90 countries by researchers, microbiologists, clinicians, public health epidemiologists, and national surveillance coordinators to manage, primarily at local and national level, results from over 1200 clinical, public health, veterinary, food, and academic laboratories for applications in basic science, clinical, and operational research;public health policy;clinical-decision support;and laboratory capacity- building. The objectives of this proposal are: a) to provide ongoing support to the existing WHONET software while integrating the latest in appropriate information technologies, ontologies, and informatics standards;b) to introduce significant enhancements to the WHONET analysis features in the areas of outbreak detection, data visualization, automation, notification, and information flow, and;c) to increase the effective utilization of WHONET by existing software users, to expand its use into new technical and geographical areas, and to promote data sharing in collaborative research networks. These developments will enhance the scientific and public health impact of our efforts and foster the strategic infrastructure required for collaborative research in developing and assessing infection and antimicrobial resistance containment interventions. Project Narrative: The continued emergence of infectious diseases, newly identified pathogens, and multi-drug resistant microorganisms is a global priority which threatens patient welfare worldwide and drains limited healthcare resources. The WHONET software, utilized in over 90 countries, provides researchers and public health authorities with tools for track emerging trends in infection and drug resistance and to develop and assess interventions for containment and control. The goal of this project is to expand WHONET in the areas of data sharing, outbreak detection, alert notification, and collaborative research in public health and scientific surveillance networks.